Take a Proactive “Health & Wealth” Strategy During Annual Benefits Enrollment

Annual enrollment typically occurs in November and December each year.  Over this period, workers have the opportunity to review options, make changes to current benefits elections and enroll in new  benefit options or programs.

Christine Cooper, CEO of aequum, urges plan sponsors and their benefits administrators to plan for a “health and wealth” strategy as a response to anticipated increases in the cost of coverage for 2024, and encourages participants to be proactive and consumer-minded throughout the enrollment process and beyond.

“We’re experiencing a period of rapid cost inflation,” says Cooper. “Renewals may see significant increases in coverage costs, leading to higher contributions from both employers and employees. This will have a compounding impact on a large segment of Americans who are financially fragile and generally unprepared for unexpected medical expenses and the  increases that are expected to result from 2024 projected increases in coverage cost – estimated to range from 5.4% to 8+%.”

Employers will be challenged to absorb the increased cost of coverage. But with inflation putting stress on their employees’ finances, budget concerns must be balanced with healthcare affordability. Plan sponsors can expect renewed focus on strategies that will rein in cost growth without shifting more cost to participants.

Plan sponsors can lower costs, achieve savings and maximize value by employing the most cost-effective resources and data-driven insights to support the health and wealth of participants. These strategies include effectively designed acquisition cost-based pharmacy pricing, HSA-capable coverage, reference-based pricing coupled with adequate participant protections against balance billing, participant advocacy and litigation support.

Enrollees Should Be Proactive and Consumer-Minded

The Employee Benefit Research Institute reveals through its annual survey that most enrollees spent less than an hour on their health plan during open enrollment. By proactively participating in the annual enrollment process, enrollees can better understand their options and optimize their benefits package to suit their needs.

Some employers will consider plan designs that change point-of-purchase cost sharing with a goal of capturing the improvement in cost management that only occurs when employees become better consumers. Jack Towarnicky, ERISA counsel, aequum, recommends employers encourage a consumer-driven approach that empowers their employees with tools and resources so they can proactively make informed, cost-conscious decisions about their healthcare options.

“Healthcare consumerism brings an opportunity to engage and better understand the information incorporated in the explanation of benefits,” says Towarnicky. “There also are strategies that take advantage of price transparency to capitalize on cost management initiatives and fully optimize value. This insight has potential to transform an employee’s health coverage usage, putting the economic purchasing power and decision-making in their hands.”

Value of a Medical Billing Partnership

To support annual enrollment and help manage plan design and administration, plan sponsors are benefiting from partnerships that provide them with insights through data-driven solutions. Real-time price information of the true cost of health care services enables sponsors and members to make the most advantageous cost-benefit decisions regarding enrollment options.

“This type of support is now readily available to the self-insured community, which is growing rapidly among US companies of all sizes,” says Cooper. “By leveling the playing field, aequum helps manage costs and gain savings to sustain affordable health coverage as a benefit.”

aequum is a first-of-its kind tech-driven company in the complex field of medical billing. “Our tech-driven team partners with health plans, providing administrative, technical and legal support to their members,” says Christine Cooper, CEO of aequum. “Working together, we are advancing solutions to manage costs, reduce spending and gain potential savings.”

As your partner, aequum can help lower costs, achieve savings, enhance member experience and maximize your plan’s success in 2024 and beyond. Please contact us if you have any questions or need support.